At a glance: Ghana

Fragile newborns survive against the odds

Lydia Atubisa and baby Awintirim. He weighed 1.3kg when he was born six weeks premature at Upper East Regional Hospital.

By Madeleine Logan

TAMALE, Ghana, 7 August 2012 - Awintirim Atubisa spent the first two months of his life tied to his mother’s chest in a cloth ‘pouch’, just like a baby kangaroo. When he was born, six weeks premature, he weighed 1.3kg and was at risk of hospital-acquired infection, severe illness and respiratory tract disease.

But he survived, thanks to the UNICEF-supported Kangaroo Mother Care program. The program encourages mothers to wrap their premature and underweight newborns to their chests using a ‘pouch.’ Snuggled against their mother’s skin, the babies’ body temperatures stabilise, their heart rates steady and they begin to breathe more easily.

Kangaroo Mother Care has been particularly successful in the Upper East and Central regions of Ghana, where babies who might have once died for want of an expensive incubator are now surviving.

“When he was alone, he would start to shake and cry. But he becomes still as soon as I tie him to me and hold him. The heat of my body makes him feel like he is still in the womb,” she said.

Margaret Kugre, the nurse in charge of the program at the Upper East Regional Hospital, said that constant skin contact between mother and baby saves the lives of fragile babies in a region where incubators are scarce and unreliable. Before Kangaroo Mother Care was introduced in 2008, up to four tiny babies would have to share the maternity ward’s only incubator, which was often broken for months at a time.

Exclusive breast feeding is another key aspect of the program. Babies are fed nothing but breast milk for the first six months of life, avoiding illnesses from contaminated water or breast milk substitutes.

The program encourages mother and baby to go home as soon as possible, to reduce the risk of hospital-acquired infection. Lydia and her son were in the hospital for one month after the birth, but as soon as he was stable and gaining weight and she could confidently tie her cloth pouch and breastfeed, they moved back home to Sandema. Awintirim and Lydia only return to the hospital for monthly weigh-ins. At his latest check-up, six weeks after delivery, he weighed nearly 2kg.

A mother and her baby on the Kangaroo Mother Care Program at Saltpond Hospital, with the nurse in charge.

In the first six months of 2011, 99 underweight babies were born in the Bolgatanga Municipal area in Ghana’s Upper East Region. All were introduced to the Kangaroo Mother Care program and all survived.

Lydia is confident her son will become strong and she has big dreams for his future: “I want him to be a doctor so he can save lives, like the doctor who saved him.”

Culture adapts to new approach

The kangaroo program has been quickly adapted into Ghanaian culture. Ms. Kugre said mothers were happy to carry their newborns on their chests but nurses also involve a woman’s husband and mother-in-law. “Carrying the baby on the back is preferred in Africa,” she said. “We work with the whole family so it is not so strange to them. In the ward, we wrap the babies onto the mother-in-law so she can feel what it’s like.”

Derek Bonsu, the Medical Superintendent at Saltpond Hospital in Central Region, said Kangaroo Mother Care empowers mothers. “They get to play an active role in the saving of their child. And no one monitors a vulnerable baby better than a desperate mother.”

Central Region also enjoys success

The program has saved hundreds of lives since it was introduced to the Central Region in 2008. Mr. Bonsu said premature and underweight babies were common and often died before Kangaroo Mother Care was introduced.

“We are in the middle of an area with social and economic problems. There is a lot of illiteracy and poverty, an early age of sexual initiation, a tradition of harmful practices, malnutrition… Mothers have had anaemia, malaria and other parasites and infections, all having an effect on the pregnancy, delivery, and health of the unborn baby. Many of the babies are born preterm or with too low a birth weight. This should not be deadly, but we did not have a functioning incubator in the hospital and were losing the babies.”

The success of the program is clear. Before June 2008, 9 out of the 16 underweight babies born at the hospital died. After the program started in June, all 12 babies born underweight lived.